Depression among elderly common

Q. I think I’m depressed. Some days I feel okay, but I often don’t feel like getting out of bed. My work is beginning to suffer. How do I know if I’m really depressed?

Q. I think I’m depressed. Some days I feel okay, but I often don’t feel like getting out of bed. My work is beginning to suffer. How do I know if I’m really depressed?

A. Your first step should be to visit your primary care physician and have a complete physical. Your problem may not be depression, but a physical condition that is causing you to feel tired.

If you have no physical problems, then you are likely suffering from depression. This could be a situational depression caused by a change in your job, home life or many other changes that we all experience during our life course. If the depression is situational, your mood may lift when change occurs or time passes. I had a patient who reported being too tired to go to work. She was not clinically depressed; she hated her job. Her energy level was restored when she was transferred to a new position.

If you have lost interest in most activities that brought you pleasure, or you’ve had mood problems before, you may be experiencing clinical depression. According to the Diagnostic and Statistical Manual, which is used by mental health professionals to make a diagnosis, feeling tired after receiving plenty of rest is a sign of depression. You may also observe some of the following symptoms:

• Agitation, restlessness or irritability

• Becoming withdrawn or isolating from others

• Difficulty concentrating and making decisions

• Changes in appetite, either eating more or less

• Feelings of hopelessness

• Trouble sleeping or sleeping too much

• Thoughts of death or suicide

If you are experiencing several of these symptoms, contact your physician again. He or she will probably prescribe medication for your depression and suggest that you meet with a mental health professional. Although the idea of psychotherapy is frightening for some people, the techniques have changed dramatically over the years. Today, most therapists help you with problem solving, changing dysfunctional behaviors and examining unrealistic thoughts. The days of the couch are virtually gone.

Q. My 83-year-old mother is depressed, but she refuses to take medication. There is nothing physically wrong with her. My father died about three years ago, and she hasn’t been the same since. I live out of town, so she is alone. What can I do?

A. Many people, especially the elderly, think that psychotropic medications are for "crazy" people. This is certainly not true. Your mother likely would not hesitate to take blood pressure medication for hypertension or insulin for diabetes. If you haven’t explained it to her in those terms, try doing so. If she will not listen to you, have her physician speak with her.

Depression among the elderly is common. Since the death of your father, your mother likely feels isolated. Additionally, she has probably experienced the deaths of many friends in the past few years. The belief that the good years are behind often causes a serious sense of loss.

You mother is likely no longer able to be as active as she once was and this leads to further depression. Knowing that she is no longer capable of doing activities she once considered normal can bring about a sense of despair.

Call often and visit your mother as much as possible. Even a short call once a day will lift her spirits. If she is depressed, she will likely not assert herself. You should contact some of her friends or family members and ask if they would visit her occasionally. If she was a church member, call the minister. Part of the mission of any church should be to care for the older members of their congregation.

If your mother does not improve after these efforts, discuss moving her to an assisted living facility near you. She likely will not want that, but it may be a choice you have to make.

Nancy Ryburn holds a doctorate degree in psychology from Yeshiva University in New York City. She currently teaches psychology at Southeast Arkansas College in Pine Bluff, Ark. If you have questions, e-mail them to nancyryburn@gmail.com. They will not be answered personally, but could appear in a future column. All e-mails remain confidential.